Provider Demographics
NPI:1558645192
Name:BROWN, MICHAEL L
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:L
Last Name:BROWN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3254 WILLIAMSON RD
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48601-5660
Mailing Address - Country:US
Mailing Address - Phone:989-615-3205
Mailing Address - Fax:989-777-5235
Practice Address - Street 1:3254 WILLIAMSON RD
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48601-5660
Practice Address - Country:US
Practice Address - Phone:989-615-3205
Practice Address - Fax:989-777-5235
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-30
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle